Medically Approved

When you need to take amphetamines to focus 

Girl with ADHD in classroom

People with ADHD and narcolepsy often need stimulants to power through their day. Here’s how to know if the combination medication amphetamine dextroamphetamine is right for you. 

Rosemary Black

By Rosemary Black

Everybody has trouble focusing occasionally. But people with Attention Deficit Hyperactivity Disorder (ADHD) find it tough to stay on task most of the time. It can also be hard to manage your time or follow directions. You feel constantly behind. 

ADHD is a type of neurodevelopmental disorder. The brain is wired differently and has been since childhood. Narcolepsy is another brain condition. That’s when the brain can’t control a person’s wake-sleep cycle. It’s almost impossible to get a good night’s rest. During the day, you’re so exhausted that you nod off during a conversation or a meeting. 

The first step is to get diagnosed. Then you can get treatment. Stimulants are a type of medication that can help, whether you have ADHD or narcolepsy. They boost the brain chemicals that help with attention and energy.  

Two common stimulants are dextroamphetamine (Dexedrine®, ProCentra®, Zenzedi®) and amphetamine (Adzenys XR-ODT®, Dyanavel® XR, Evekeo®, Evekeo ODT®). Sometimes doctors prescribe them separately, sometimes in combination.  

“There isn’t a lot of difference between how effective they are,” says Justine Larson, MD. She’s the medical director at Sheppard Pratt, a provider of nonpublic special education programming in Baltimore. “But people react differently to different medications, so you may be prescribed one or the other or both together.” 

No matter how you take dextroamphetamine and amphetamine, you want to know how they work, their side effects and more. Read on to get the scoop. 

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How does the amphetamine dextroamphetamine combination work? 

The combination, known as amphetamine dextroamphetamine (Mydayis®, Adderall®, Adderall XR®), works the way most stimulants do. It activates the brain so that you release 2 important chemicals: dopamine and norepinephrine, explains Alyssa M. Wozniak, PharmD. She’s a clinical assistant professor at the School of Pharmacy at D’Youville University in Buffalo, New York. “This can result in improved focus or energy,” she adds. 

It’s especially helpful if you have narcolepsy. Amphetamine dextroamphetamine can help keep you awake during the day so that you can do more things without the danger of falling asleep.  

If you have ADHD, this combination medication can help with executive function, says Dr. Larson. That’s the part of the brain you use to plan your time, problem-solve, make decisions and concentrate. 

Recommended reading: The grown-ups’ guide to ADHD. 

Who can take amphetamine dextroamphetamine? 

It depends on the medication: 

  • Adderall: For ADHD, kids age 3 and up and adults; for narcolepsy, anyone age 12 and up 
  • Adderall XR: Anyone age 6 and up with ADHD 
  • Mydayis: Anyone age 13 and up with ADHD 

Some people shouldn’t be on any kind of amphetamines. That includes people with heart disease or heart conditions. These medications raise the risk of a sudden heart attack in kids and teens. And it raises the risk of strokes and heart attacks in adults. 

That’s why a doctor will take a complete family medical history and do an exam, says Wozniak. Your provider will look for signs of an irregular heartbeat and ask if anyone in the family had a sudden and deadly heart attack. If there’s any sign of heart disease or issues, you might have to take something else. 

How to take amphetamine dextroamphetamine 

It depends on the type you take. The medication comes in immediate-release or extended-release forms. So that affects when and how you take it.  

Adderall comes as an immediate-release tablet and works quickly. It reaches peak effect roughly 3 hours after you take it. The effects last around 4 to 6 hours, says Wozniak.  

  • Take Adderall 2 or 3 times a day, 4 to 6 hours apart.  
  • Take it with or without food. 

Adderall XR and Mydayis come as extended-release capsules. They work more slowly and last longer. The medication reaches peak about 7 hours after you take it, Wozniak says. It acts for about 12 to 16 hours in total. 

  • Take Adderall XR when you wake up, with or without food.  
  • Take Mydayis when you wake up. You can take it with food or without. But whatever you decide, stick with it.  
  • Swallow the capsule whole. Or break it apart and sprinkle the contents in a teaspoon of applesauce. Swallow that mixture whole. Don’t chew it. 

Your doctor will probably start you on a low dose. Then you’ll go in for checkups every 2 to 4 weeks until you reach the dose that works best, says Wozniak. After that, your doctor will see you every 3 months, she adds.  

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Does amphetamine dextroamphetamine have side effects? 

The most common side effects are GI issues — queasy stomach, constipation or diarrhea. You might not have much appetite. You could have problems sleeping, too.   

“It’s quite common to have trouble falling asleep,” Dr. Larson says. Lack of sleep can impact a child’s development. “So for children on stimulant medications, you would follow their weight to make sure they’re eating enough and growing well.” 

For adults, if insomnia keeps you up, switch to the shorter-acting form (Adderall). Or take the medication even earlier in the day, says Wozniak. 

Other side effects include: 

  • Headaches 
  • Irritability 
  • Feeling agitated  
  • Tics (sudden twitches, movements or sounds that people do repeatedly)

“If a person develops tics, they should discuss it with their health care team, as there are ways to manage it,” notes Wozniak. 

More serious side effects could be signs of a heart problem or stroke, including: 

  • Shortness of breath or trouble breathing 
  • Chest pains 
  • Fainting 
  • Slow speech 
  • Numbness in your leg or arm 

The potential problems with taking amphetamine dextroamphetamine 

This medication is considered a controlled substance. That means you could become addicted to it. But not always. That’s why doctors tend not to prescribe this and other amphetamines long term, says Wozniak. And your health care team will monitor you, looking for signs of abuse and dependence.  

“The fact that this medication is a controlled substance puts extra safeguards and regulations in place in hopes of preventing substance abuse or dependence from occurring,” Wozniak says. 

Despite these pitfalls, this medication has many benefits. One of the biggest? People with ADHD and narcolepsy have more control over their lives.  

(No matter how you manage your narcolepsy or ADHD, Optum Perks wants to help you save at the pharmacy. Here’s how it works.) 

 

Additional sources:
ADHD facts: National Institute of Mental Health 
Narcolepsy fact sheet: National Institute of Neurological Disorders and Strokes 
Teens on stimulants: Journal of Clinical Psychiatry (2003). “Does stimulant treatment lead to substance use disorders?”